This topic is about the concerns and preparations involved in a colostomy reversal and how to manage a colonoscopy prep when you have a stoma. Here are some key points and advice shared by others who have been through similar experiences:

- Thirteen months after having a colostomy, a general practitioner suggested the possibility of a reversal, but the surgeon requires a colonoscopy first. The person is unsure about how to prepare for a colonoscopy with both a stoma and an inactive rectum/anus.

- They have been informed that a reversal is considered major surgery, potentially more significant than the initial emergency operation that created the colostomy due to a bowel perforation.

- The lack of information, mixed stories about outcomes, and concerns about a possible parastomal hernia (a bulge around the stoma area) are causing anxiety.

- Currently, they use a Hollister two-piece system without follow-up from a stoma nurse and use a large ACE bandage as a makeshift hernia wrap because commercial wraps feel too bulky.

- They are seeking first-hand experiences with colonoscopy prep through a stoma and honest feedback on the success and recovery from a reversal.

General Reversal Considerations:
1. Ensure that the condition that led to the colostomy, such as a perforation or sepsis, is fully resolved before considering a reversal.
2. Determine if the stoma is a loop or temporary design, as this affects the possibility of reversal.
3. Research surgeons thoroughly and review medical literature on success rates to avoid a failed reversal.

Colonoscopy Preparation with a Stoma:
1. Only the functioning bowel segment leading to the stoma needs preparation; little or no prep is usually required for the inactive rectum.
2. Typical instructions include consuming liquids the night before and using only half the usual volume of GoLYTELY (PEG) since output evacuates faster through the stoma.
3. For scope insertion, a pediatric-diameter colonoscope may be used to comfortably enter the stoma. Both the rectum/anus and the stoma can be scoped in the same session.
4. Long "prep" pouches or improvised tubing can help manage high-volume output more easily.

Extra Bowel Cleanse Before Reversal Surgery (Based on One Member's Experience):
1. Follow a two-day clear-liquid diet, then a 24-hour fast.
2. Take oral magnesium citrate the night before.
3. Use a bisacodyl enema 4 hours before the operation.
4. Pre-operative EKG and routine bloodwork clearance are required.

Surgical Details & Recovery Anecdotes:
1. Even if planned as laparoscopic or robotic, dense scar tissue may necessitate conversion to open surgery with multiple abdominal incisions.
2. Expect abdominal muscles to be reopened, the stoma site closed, and a new bowel connection made. Pain and fatigue may be greater than the original surgery, though hospital stays are typically shorter (4-6 days reported).
3. Arrange for home support in advance, as lack of nursing or home help made recovery difficult for one person who also had to care for an elderly parent.
4. Weight and nutrition are important; one person is intentionally gaining 5-10 pounds before reversal to aid healing.
5. Rest well before the operation and be prepared for possible hernia repair or stoma-site issues during the reversal.

Supply & Product Notes:
1. Hollister two-piece ostomy appliances were provided upon discharge.
2. GoLYTELY (polyethylene glycol electrolyte solution) is used for bowel prep.
3. Magnesium citrate oral laxative and bisacodyl enemas are specified.
4. Longer prep-specific pouches are available from ostomy supply manufacturers, and online retailers can help fill any gaps.